Boat Insurance Quote - JW Davis Insurance Brokers

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Monday to Friday

Mississauga,

Ontario, L5J 2V8

905-822-9660

877-593-2847

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December 2, 2020

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09:00 – 17:00

Monday to Friday

Mississauga,

Ontario, L5J 2V8

905-822-9660

877-593-2847

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Contact Us

Boat Insurance Quote

February 16, 2016by JWDavis

Boat Insurance

Step 1 of 7

14%

Owner’s Name:*
First Last
Address*
Street Address Address Line 2 City Province Postal Code
Telephone Number:*
Your Email*
When should coverage start:*
Date Format: MM slash DD slash YYYY
Do you belong to a Canadian Yachting Association:

Manufacturer and Model of Vessel:
Year*
Manufacturer and Model*
Purchase Date*
Date Format: MM slash DD slash YYYY
Length*
Boat HIN#
Tender HIN#
Aux Motor Serial #
Vessel Type:*
- Sail
- Motor
- Multi-Hull
- Other
If Other, please describe:
Method of propulsion:*
- Outboard
- Inboard/Outboard
- Inboard
- Jet
- Fishing Utility
- Bass Boats
- Fishing Runabouts
- Other – Describe:
- Runabout Utility
- Bowrider
- Closed-Deck Runabouts
- Ski Boat
- Performance/Sport Boat
- House Boat
- Midcabin Cruiser
- Motor Yacht
- Deck Boat
Hull Material:*
- Wood
- Aluminum
- Fiberglass
- Other
If Other, please describe:
Metallic Flake Finish:*
Engine Make*
Year:*
Total Horsepower:*
Maximum Top Speed:*
Fuel:*
Purchase Price:*
Current Market (Resale) Value:*
Replacement Value:*

Equipment: From the following list check the appropriate equipment which is installed in the vessel or portable in nature but used specifically in theoperation of the vessel and included in Hull Insurance.
Trailer used:
- Trailer used solely for transportation of the Insured yacht:
Year:
Serial No.:
Manufacturer:
Value:
Tender used:
- Tender used solely for transportation between the insured vessel and shore:
Year:
Serial No.:
Manufacturer:
Length:
Value:
Outboard Motor use:
- Outboard Motor used with tender, or as auxiliary
Model Year:
Serial No.:
Manufacturer:
HP:
Value:
Radar
Fathometer or Depth Sounder
Sonar
Direction Finder
C.B. Radio/V.H.F.
Other (Please describe):
Cradle
Built-in Fire Extinguishing System?
Built-in Fire Extinguishing System:
- CO2
- Halon
- Automatic
- Manual
- Other
Auto Bilge Pumps:
- Engine Blower
- Vapour/ Fume Detector
- Smoke Detector/Alarm
Auxiliary Generator (Type of Fuel):
Other (Please describe):
Is Boat equipped according to Federal Coast Guard Standards?
Appliance Type - Stove/Barbaque
Appliance Type - Stove/Barbaque
Pilot Light
If Propane/Butane, Natural Gas is used, where is tank located?
If Propane/Butane, Natural Gas is used, is vapour vented externally?
Appliance Type - Furnace/Heater
Appliance Type - Furnace/Heater
Pilot Light
If Propane/Butane, Natural Gas is used, where is tank located?
If Propane/Butane, Natural Gas is used, is vapour vented externally?
Appliance Type - Refrigeration
Appliance Type - Refrigeration

Berthing & Navigation:
If you sign a “Hold Harmless” agreement with your Yacht Club or Marina you must forward a copy of this agreement to us immediately:
Summer
Location:
Mooring Berth:
Winter
Location:
Lay-up Berth:
From:
Date Format: MM slash DD slash YYYY

Lay-up Coverage: Coverage contemplates a Lay-up Period from November 15th to March 31st.If lay-up period is different, please indicate.
To:
Date Format: MM slash DD slash YYYY

Lay-up Coverage: Coverage contemplates a Lay-up Period from November 15th to March 31st.If lay-up period is different, please indicate.
Is extension of Navigation Limits required?
Describe:

Pleasure used only?
If Boat corporately owned, provide specific details of usage:
Is Boat used Commercially or Chartered :
Describe:
Are you chartering your yacht?
How long have you been employed in commercial operations?
What is the period during which commercial operations are carried out?
What limit of liability is required?
INPUT $
What are the estimated annual gross receipts?
INPUT $
Does Applicant employ a paid crew or captain?
What is the passenger capacity of your vessel?
Water skiing/Tubing/Knee Boarding?
Racing:
Describe:

Qualifications and experience of all operators:
Name 1:
First Last
Date of Birth 1
Date Format: MM slash DD slash YYYY
Have you previously owned a pleasurecraft
No. of Years
Number of years of experience as operator
Years of experience this type of vessel
Name #2
Name 2:
First Last
Date of Birth 2
Date Format: MM slash DD slash YYYY
Have you previously owned a pleasurecraft
No. of Years
Number of years of experience as operator
Years of experience this type of vessel
Name #3
Name 3:
First Last
Date of Birth 3
Date Format: MM slash DD slash YYYY
Have you previously owned a pleasurecraft
No. of Years
Number of years of experience as operator
Years of experience this type of vessel
Name #4
Name 4:
First Last
Date of Birth 4
Date Format: MM slash DD slash YYYY
Have you previously owned a pleasurecraft
No. of Years
Number of years of experience as operator
Years of experience this type of vessel
Boat courses taken:
Describe:
Loss History:
Please list in detail any known and/or reported boating, property, automobile losses and/or infractions for the past five years for all operators:
Please list previous Insurer:*
Has insurance been refused or cancelled by any Company?

Vessel

INPUT $ (A)
Equipment

INPUT $ (B)
Total Hull
$ 0.00 CAD
INPUT $ (A+B)
Limit of Liability
INPUT $
Limit Personal Effects
INPUT $
Notes

J. W. Davis Insurance Brokers LTD

We are offering standard and most specialty general insurance. Based in Mississauga but reaching Province wide, our goal is to cater to and tailor our clients insurance to their specific needs.

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